What are the symptoms of prostate issues?

We often assume that urinating more frequently or waking up during the night is just a normal part of aging.

But is that really the case? We sat down with Dr. Pittari, a staff urologist and andrologist, to understand when a simple inconvenience points to an underlying condition—and why, contrary to popular belief, an enlarged prostate isn’t always a disease in itself.

Read on to discover the signals your body is sending you and when it’s time to stop waiting.

Doctor, when should a patient book an appointment?

Generally, men see an urologist for two main reasons.

The first is an elevated PSA reading. PSA is a prostate-specific biomarker routinely ordered by primary care physicians. A higher-than-normal PSA level serves as a warning sign, opening the door to preventive screening for prostate cancer, which can then be evaluated through various diagnostic steps.

The second—and far more common—reason, accounting for about 9 out of 10 visits, is a cluster of lower urinary tract symptoms (dysuria). Essentially, men notice changes in their urination habits compared to when they were younger. They primarily report waking up at night, frequent trips to the bathroom, sudden urgency, minor leakage, or a urinary stream that has weakened or shortened over time.

What are the most common symptoms and how are they managed?

Patients experiencing these urinary symptoms are typically treated with medication first. If pharmacotherapy fails to provide relief, surgical options are considered.

One crucial takeaway is that an enlarged or hardened prostate is not, in and of itself, a disease. The actual medical issue is the obstruction of urine flow—specifically, the exit of urine from the bladder being blocked by the prostate’s condition. Therefore, drug therapy is always the first line of defense, with surgery re-evaluated if medication proves ineffective or yields suboptimal results.